2775/2614/SpeedPost

To,
Mr. MKL..
C/o wrohsklfn
Reprocf,m;;
Sfgppkerknf
Maharashtra - 999999
Mobile No: 0000000000
Policy No: 90000002

Agency code : 99999999

Agency Name : Branch Name : dalfj
Contact Number : 0

Dear Mr. Mahesh Mallikarjun Bhogaonkar,

This page is intentionally left blank.

Congratulation! You are now a step closer to provide financial protection to your dependents and we are glad to be a
part of this journey with you.
We have designed all our plans to meet your needs at different stages of your life.
We have provided you the relevant information about your plan in this plan document. This document is simple to
understand. Please read it carefuly and make sure that this right plan for your financial needs. The document also
carries important information on how you can benefit from this plan using its various feartures.
If you are not happy with any of the planss features or feel that this is not the right plan for you at the moment, you
can change or return it to us within 15 days from the date of receiving it, quoting your reasons. Our customer care
executive will be happy to help you.
If you return your plan, we will pack back your premium after deducting the stamp duty, mortality charges and
medical charges as applicable.
Thank you once again for choosing IndiaFirst.
Yours truly,

Dr. P Nandagopal
Managing Director and CEO

2775/2614

20

This page is intentionally left blank.

This page is intentionally left blank.

2775/2614

19

First Premium Receipt

Mr. MKL..
C/o wrohsklfn
Reprocf,m;;
Sfgppkerknf
Maharashtra - 999999
Mobile No: 0000000000
Premium Payment Details

This page is intentionally left blank.

Name of the Plan:

IndiaFirst Anytime Plan

Policy No

90000002

Name of the Policy Holder

Mr. MKL..

Plan Name

IndiaFirst Anytime Plan

UIN of Plan

143N009V01

Premium Received
(excluding service tax and education cess)

2,160.00

Service tax

216.52

Education cess

6.48

Total premium received

2,383.00

Payment Mode

Annual

Next Premium Due

24/01/2012

Please note:
n

If you are an individual, your premiums paid under the plan, are eligible for tax deductions under Section 80C as applicable
under the Income Tax Act, 1961

Tax laws are subject to change from time to time. Please refer to the Policy Schedule available with the Plan Documents for
further details.

This is a computer generated receipt and does not require a signature

Please feel free to contact us for any further information, on 1800-209-8700 or email us at customer.first@indiafirstlife.com or
visit us at www.indiafirstlife.com .
Consolidated Stamp Duty paid Notification No Mudrank No. AMUSHU-2010/C.R.333/M-1 dated 23/06/2010.
Service Tax Registration Number: AADCB6215GST001

2775/2614

18

2775/2614

Annexure C: List of Ombudsman

Office of the
Ombudsman

Contact Details
Insurance Ombudsman Office of the Insurance Ombudsman
2 nd floor, Ambica House, Nr. C.U.Shah College, 5, Navyug Colony,
Ashram Road,
AHMEDABAD 380 014
Tel.079- 27546150, Fax:079-27546142, E-mail:
insombahd@rediffmail.com
Insurance OmbudsmanOffice of the Insurance Ombudsman
Janak Vihar Complex, 2 nd floor, Malviya Nagar, BHOPAL
Tel.0755-2769201/02, Fax:0755-2769203,
E-mail: bimalokpalbhopal@airtelbroadband.in

Areas of
Jurisdiction
Gujarat , UT of Dadra &
Nagar Haveli, Daman and
Diu

AHMEDABAD

Shri Amitabh

BHOPAL

Shri N.A.Khan

BHUBANESHWAR

Shri S.K.Dhal

Insurance OmbudsmanOffice of the Insurance Ombudsman

62, Forest Park, BHUBANESHWAR 751 009, Tel.06742596461(Direct), Secretary No.:0674-2596455, Tele Fax - 06742596429, E-mail: ioobbsr@dataone.in

Orissa

Shri K.M.Chadha

Insurance Ombudsman Office of the Insurance Ombudsman

nd
S.C.O. No.101, 102 & 103 2 floor, Batra Building, Sector 17-D,
CHANDIGARH 160 017
Tel.: 0172-2706196, Fax: 0172-2708274, E-mail: ombchd@yahoo.co.in

Punjab , Haryana,
Himachal Pradesh, Jammu
& Kashmir , UT of
Chandigarh

CHENNAI

Insurance Ombudsman Office of the Insurance Ombudsman

Fatima Akhtar Court , 4 th floor, 453 (old 312) Anna Salai, Teynampet,
CHENNAI 600 018
Tel. 044-24333678 Fax: 044-24333664, E-mail:
insombud@md4.vsnl.net.in

Tamil Nadu, UT
Pondicherry Town and
Karaikal (which are part of
UT of Pondicherry)

NEW DELHI

Insurance Ombudsman Office of the Insurance Ombudsman

2/2 A, Universal Insurance Bldg. Asaf Ali Road, NEW DELHI 110 002
Tel. 011-23239611, Fax: 011-23230858, E-mail: iobdelraj@rediffmail.com

Delhi & Rajashthan

CHANDIGARH

This page is intentionally left blank.

Name of the
Ombudsmen

GUWAHATI

HYDERABAD

Shri Sarat Chandra

Sarma

Shri P.A.Chowdary

ERNAKULAM

Shri James Muricken

KOLKATA

Shri
K.Rangabhashyam

LUCKNOW

MUMBAI

Insurance Ombudsman Office of the Insurance Ombudsman

Jeevan Nivesh, 5 th floor, Nr. Panbazar Overbridge , S.S. Road,
GUWAHATI 781 001
Tel. : 0361-2131307 Fax:0361-2732937, E-mail: omb_ghy@sify.com
Insurance Ombudsman Office of the Insurance Ombudsman
6-2-46 , 1 st floor, Moin Court Lane Opp. Saleem Function Palace,
A.C.Guards,
Lakdi-Ka-Pool HYDERABAD 500 004
Tel. 040-23325325, Fax: 040-23376599, E-mail:
hyd2_insombud@sancharnet.in
Insurance Ombudsman Office of the Insurance Ombudsman
2 ND Floor, CC 27/2603, Pulinat Building , Opp. Cochin Shipyard, M.G.
Road , ERNAKULAM 682 015
Tel: 0484-2358734, Fax:0484-2359336, E-mail:
iokochi@asianetglobal.com
Insurance Ombudsman Office of the Insurance Ombudsman,
North British Bldg., 29, N.S. Road , 3 rd floor, KOLKATA 700 001
Tel.:033-22134869, Fax: 033-22134868, E-mail : iombkol@vsnl.net

Madhya Pradesh &

Chhattisgarh

Assam , Meghalaya,
Manipur, Mizoram,
Arunachal Pradesh,
Nagaland and Tripura
Andhra Pradesh,
Karnataka and UT of
Yanam a part of the UT
of Pondicherry

Kerala , UT of (a)
Lakshadweep , (b) Mahe
a part of UT of
Pondicherry
West Bengal , Bihar ,
Jharkhand and UT of
Andeman & Nicobar
Islands , Sikkim

Shri M.S.Pratap

Insurance Ombudsman Office of the Insurance Ombudsman

Jeevan Bhawan, Phase 2, 6 th floor, Nawal Kishore Rd. Hazratganj,
LUCKNOW 226 001
Tel.:0522-2201188, Fax: 0522-2231310, E-mail: ioblko@sancharnet.in

Uttar Pradesh and

Uttaranchal

Shri R.K.Vashishtha

Insurance Ombudsman Office of the Insurance Ombudsman,

Jeevan Seva Annexe, 3 rd floor, S.V.Road, Santacruz(W), MUMBAI
400 054
PBX: 022-26106928, Fax: 022-26106052, E-mail: ombudsman@vsnl.net

Maharashtra , Goa

2775/2614

17

ANNEXURE A: Policy Schedule

Dispute with regard to premium.

Non-receipt of your insurance document.

Company name
Product name
UIN number

The complaint should be made in writing duly signed by the complainant or by his legal heirs with full details
of the complaint and the contact information of complainant.
As per provision 13(3) of the Redressal of Public Grievances Rules 1998, the complaint to the Ombudsman

Client details

can be made -

Name of the Policyholder:

Name of the Life Assured:
Plan Commencement Date:
Client ID
Date of Risk Commencement:

Only if the grievance has been rejected by Our Grievance Redressal Machinery (Customer Care
Person).

Within a period of one year from the date of rejection by us.

If it is not simultaneously under any litigation.

IndiaFirst Life Insurance Company Limited

IndiaFirst Anytime Plan
143N009V01

Mr. MKL..
Mr. MKL..
2 4 0
51254361
2 4 0

Nominee (as per section 39 of the Insurance Act, 1938)

Name of the Nominee

Date of birth:
Age:
Age admitted
Gender

2 4 0 4
34 years
Y
M

0 4

Mrs IOP

* If any of the Nominees is a minor the Appointee will be the person named as the Appointee in the Proposal Form

Plan details
Policy number:
Sum Assured:
Installment premium:
Premium frequency:
Last premium due date:

90000002
Rs 1,000,000.00
Rs 2,383.00
Annual
2 4 0 1 2

Application number:
Policy term:
Plan Maturity Date:

O10000290
30 years
2 4 0 1 2

0 4 0

Special conditions
NIL

The Stamp Duty of Rs. 200.00/- (Rupees Two Hundred only) paid by pay order, vide receipt no. 34869 dated 3rd December 2010. Government
Notification Revenue and Forest Department No.Mudrank 2004/4125/CR/690/M-1,dated 31.12.2004.

2775/2614

16

Endorsements (if any)

What happens in case of loss of the Plan document?
If the Plan document is lost or misplaced, you will give us a written request stating the fact and the reason of
the loss. If we are satisfied that the Plan document is lost, we will issue you a duplicate Plan document. On
the issue of the duplicate Plan document, the original Plan document will immediately and automatically
become invalid.
You agree to indemnify us and hold us free and harmless from any costs, expenses, claims, awards or
judgments arising out of or in relation to the original Plan document.

Issuing Notices
We also have the discretion to issue either individual notices to you or publish general notices on our
website.

12. Governing Laws and Jurisdiction

All claims, disputes or differences arising under or in connection with this Plan will be governed by and
construed in accordance with Indian law and determined by the Indian Courts.

13. Grievance Redressal

Any grievance/complaint pertaining to this Plan may be addressed to our corporate office, at the following
address IndiaFirst Life Insurance Company Ltd.
301, 'B' Wing, The Qube, Infinity Park,
Dindoshi - Film City Road, Malad East,
Mumbai 400 097
Contact No: 18002098700
Email Id: customer.first@indiafirstlife.com

In case you are not convinced with the decision of the above office or have not received any response within
10 days, you may contact our Customer Care person for a resolution:
Email Id: grievance.redressal@indiafirstlife.com

In case however, you are not satisfied with our decision/resolution, you may approach the nearest
Ombudsman from the list of Ombudsmen if your grievance pertains to

An insurance claim that has been rejected or dispute of a claim on legal construction of the Plan.

Delay in settlement of claim.

2775/2614

15

Provisions of Section 45, Insurance Act, 1938

IndiaFirst Anytime Plan

The Plan is subject to the provisions of Section 45 of the Insurance Act 1938 which states as follows

No Policy of life insurance effected after the coming into force of this Act shall, after the expiry of two years
from the date on which it was effected, be called in question by an insurer on the ground that a statement

Contents

made in the proposal for insurance or in any report of a medical officer, or referee, or friend of the insured, or

Page No.

in any other document leading to the issue of the Policy, was inaccurate or false, unless the insurer shows

Definitions

Executive summary

About your plan

Benefits under the plan

Nomination

Missing your premiums

Loan/ assignment

10

Plan ceases/ ends

10

Surrendering the plan

10

Making a claim

11

10

Change of address

11

11

Disclosures

11

12

General conditions

12

13

Governing laws and jurisdiction

13

14

Grievance redressal

13

that such statement was on a material matter or suppressed facts which it was material to disclose and that
it was fraudulently made by the Policyholder and that the Policyholder knew at the time of making it that the
statement was false or that it suppressed facts which it was material to disclose. Provided that nothing in this
section shall prevent the insurer from calling for proof of age at any time if he is entitled to do so, and no
Policy shall be deemed to be called in question merely because the terms of the Policy are adjusted on
subsequent proof that the age of the life insured was incorrectly stated in the proposal.

Making untrue/ incorrect statements or withholding information

If you or the Life Assured or the Nominee or anyone acting on your/their behalf advances any claim knowing
the same to be false, dishonest or fraudulent, then this Plan will be void and any amounts paid or potentially
payable under the Plan will be forfeited.

False disclosure about Age

The Life Assureds Age has been admitted on the basis of the information provided by you, the Life Assured/
Policyholder.

If the Life Assureds Age is found to be different from that declared, we may, at any time during the Plan
Term, adjust the Premiums and/or the benefits under this Plan and/or recover the applicable balance
amount, if any, as we deem fit. The Plan will however become void from Plan Commencement Date, if the
Life Assureds Age at the Plan Commencement Date is found to be higher than the maximum or lower than
the minimum entry age that was permissible under this Plan at the time of its issue and subject to Section 45
of the Insurance Act, 1938, the amounts received under this Plan will be liable to be forfeited, at our option.

11. General Conditions

Our rights to review, revise, delete or alter the terms and conditions of the Plan
We may review, revise, delete and/ or alter any of the terms and conditions of the Plan with the prior
approval of the Regulatory Authority by sending you prior written notice of 30 days.

14

2775/2614

Definitions

*Unexpired Term will be calculated as on the date of lapse or, in case the cover is continuing, the date of

Listed below are a few words used in this document along with their meaning for your easy reference. Please

surrender

go through the same before proceeding further.

Word
Age
Appointee
Annexure
Business Day
Date of Risk
Commencement
Death Benefit
Financial Year
Life Assured
Nominee

Plan

8. Making a claim

Meaning

Steps involved in making a claim

The Age of the Life Assured as on his/her last birthday.

The person who receives the proceeds or the benefits under the Plan when the
Nominee is less than 18 years of Age.
Any document attached to this Plan as amended from time to time.
Any usual working day of our corporate office in Mumbai.
The date from which the Death Benefit is activated under the Plan. This date is
specified in the Plan Schedule.
The amount which is payable on the Life Assureds death as specified in the Plan.
A period of 12 months, starting from 1st April every calendar year and ending on
31st March the following calendar year.
Example: 1st April, 2010 to 31st March, 2011 is considered as one Financial Year.
The person named in the Plan Schedule and, on whose life the Plan depends. The
benefit is paid out by us and the Plan ends on the Life Assureds death.
The person nominated by you to receive the Death Benefit as specified in the Plan.
The IndiaFirst Anytime Plan is a pure protection plan. It includes this Plan wording,
the Proposal Form, the Sales Illustration, Annexures and the Plan Schedule which
is attached to and form a part of this Plan.

You or your Nominee/ Appointee or legal heir, as the case may be, will

Give us a written notice of the claim on the Life Assureds demise

Give us all the relevant information in writing to enable us to process the claim as specified in the
Plan.

Documents required at the time of making a claim

Proof of Age of the Life Assured, if age has not been admitted.

Claimants statement.

Death certificate issued by the local health and medical authority.

Copies of First Information Report, post mortem report, duly attested by police officials, in case of
unnatural deaths including accidents etc.

Hospitalization documents (discharge summary, all investigation reports) in case the Life Assured
was treated for any illness related to the cause of death.

Plan Commencement
Date
Plan Maturity Date

Plan Year

Plan Schedule
Plan Term
Premium Paying
Term
Policyholder
Proposal Form
Regular Premium
Regulations

In this document, Plan will mean Policy and may be used interchangeably.
The date on which the Plan starts as specified in the Plan Schedule in Annexure A.

Original Plan Document

Any other document or information that we may need to process the claim depending on the cause
or nature of the claim.

The date on which the Plan ends as specified in the Plan Schedule in Annexure A.
A period of 12 consecutive months commencing from the Plan Commencement
Date and ending on the day immediately preceding its annual anniversary and
each subsequent period of 12 consecutive months thereafter during the Plan Term.
Example: If the Plan Commencement Date is 18th October, 2009 the first Plan Year
would be 18th October, 2010 to 17th October, 2011.
The schedule to this Plan attached as Annexure A.
The period which commences on the Plan Commencement Date and ends on the
Plan Maturity Date as specified in the Plan Schedule.
The number of years, during which you will pay your Regular Premium as specified
in the Plan Schedule.
The person who proposes to take the Plan for the Life Assured and pays the
premium on behalf of the Life Assured. The Policyholder and the Life Assured may
be the same person in the Plan.
The completed online application form based on which we have issued this Plan.
The amount you pay us during the Plan Term at regular intervals as specified in the
Plan Schedule.
The applicable laws as amended from time to time which are applicable to this

Payment of benefits in Indian Rupees

All benefits and other sums under this Plan are paid in India and in Indian Rupees.

9. Change of address
You are required to inform us in writing, about any change in your address. This will ensure that our
correspondence reaches you without any delay.

10. Disclosures
Misrepresentation/ fraudulent disclosures
In issuing this Plan, we have relied on the truth, accuracy and completeness of information provided by you
while filling the Proposal Form online. We believe that the statements and declarations made by you are true
and correct, which form a part of and are the basis of this Plan.

13

5. Loan or Assignment
Regulatory Authority

Loan benefits under the Plan

We will not offer any loans under this Plan.

Single Premium

Assignment of the Plan

You may assign the Plan by making an endorsement on the Policy itself, or

Making the assignment through a separate instrument.

Sum Assured
Surrender
We, Us or Our
You or Your

In either case, you need to write to us requesting for registering the assignment.

Plan.
The Insurance Regulatory and Development Authority or such other authority or
authorities, as may be designated/appointed under the applicable laws and
regulations as having the authority to oversee and regulate life insurance business
in India.
The amount received by us in one lump sum as specified in the Plan Schedule
before the Plan Commencement Date.
The amount specified in the Plan Schedule.
Terminating or cancelling or stopping the Plan prior to the Plan Maturity Date.
IndiaFirst Life Insurance Company Limited
Policyholder

Executive summary
Key features

Assignment and Death Benefit

The assignee cannot increase the Sum Assured.

No intermediaries, no time restrictions - you can now get your life cover anytime and anywhere by
directly logging onto our website www.indiafirstlife.com

Our liability in an assignment

The Life Assureds family is secured, as they get an assured lump sum benefit, in case of the Life
Assureds untimely death.

In accepting or recording an assignment, we do not accept any responsibility or express any opinion as to its
validity or legal effect.

Risk factors

6. Plan ceases/ ends

The Plan will cease immediately and automatically on the happening of the earliest of the following -

There is no maturity or survival benefit payable under this Plan.

This is a non participating pure term assurance Plan.

Life Assured attaining 71 years of Age.

Life Assureds demise.

Interpretation

Surrendering of Plan.

This Plan is divided into numbered sections for ease of reference and reading only. Except as otherwise

End of the Plan Term.

stated, these divisions and the corresponding section headings do not limit the Plan or its interpretation in

The Plan lapses and is not revived within the revival period

any way.

Words of one gender will include the other gender and the singular will include the plural and vice versa,

7. Surrendering the Plan/ Cover

unless the context otherwise requires.

You have the flexibility to Surrender your Plan.

Regular Premium

No Surrender value is payable

Single Premium

Surrender value is payable only if you Surrender

1. About your Plan

the Plan any time after the 3rd Plan year and

In a nutshell

before the end of the Plan Term. It is calculated as

IndiaFirst Anytime Plan is a pure protection Plan.

Un exp iredTerm*
40% Pr emiumsPaid

TotalTerm

The plan is available directly through the internet

12

We will use the Single Premium or Regular Premium (as applicable) paid by you to provide the Life

3. Nomination

Cover. The benefits are payable on the Life Assureds death.

Appointing a Nominee to receive the Death Benefit

Eligibility criteria

Minimum Age at entry

18 years as on last birthday

Maximum Age at entry

60 years as on last birthday

Maximum Age at maturity

70 years as on last birthday

If You and the Life Assured are the same person, you may at any time during Plan Term and while the
Plan is force, make a nomination,

The Death Benefit will be payable to your legal heirs or representatives if there is no Nominee or if all the
Nominees have pre-deceased the Life Assured.

2. Benefits under the Plan

If the Nominee is a minor
Death Benefit

You may appoint an Appointee to receive and hold the Death Benefit until the Nominee attains 18 years of

We will pay the Death Benefit to the Nominee in the unfortunate event of the Life Assureds death (after the

Age.

Date of Risk Commencement and before the Plan Maturity Date).

Making a nomination
Calculation of Death Benefit

You may make or change a nomination by writing to us. The nomination or change will become effective only

The Death Benefit is the Sum Assured.

after it is recorded by us.

Death Benefit claim not admitted

Our liability in a nomination

If the Life Assured commits suicide within 12 months from the Date of Risk Commencement or the date of

In accepting or recording a nomination or a change of nomination we do not accept any responsibility or

revival of this plan, no death benefit will be payable under the plan except for single premium mode wherein

express any opinion as to its validity or legality.

surrender value (if any) will be paid in such events. This is irrespective of whether the life assured was sane

4. Missing your Premium

or insane at the time of death.

We provide you a grace period of 30 days in case of six-monthly or yearly premium mode and 15 days in

Maturity benefit

case of monthly premium mode. This period starts from the due date of each premium payment. All your

There is no maturity benefit in this Plan. This is a non participating pure term assurance Plan.

plan benefits continue during this grace period.

Rider benefits

If you do not pay your premiums before the end of the grace period, the Life Cover ceases and your Plan will
lapse.

There are no riders available under this Plan.

Option of reviving the lapsed plan

Payment of benefits

You may revive the Plan by paying the unpaid premiums within two years from the due date of first unpaid

The benefits will be paid to the Nominee only after the Life Assureds demise.

premium subject to satisfactory medical and financial underwriting. You will have to bear the cost of
underwriting/ medicals.

10

11